Criticisms of African trials fail to withstand scrutiny: Male circumcision DOES prevent HIV infection
Richard G Wamai, Brian J Morris, Jake H Waskett, Edward C Green, Joya Banerjee, Robert C Bailey, Jeffrey D Klausner, David C Sokal, Catherine A Hankins
A recent article in the JLM(Boyle GJ and Hill G, “Sub-Saharan African Randomized Clinical Trials into Male Circumcision and HIV Transmission: Methodological, Ethical and Legal Concerns” (2011) 19 JLM 316) criticises the large randomised controlled trials (RCTs) that scientists, clinicians and policy-makers worldwide have concluded provide compelling evidence in support of voluntary medical male circumcision (VMMC) as an effective HIV prevention strategy. The following article addresses the claims advanced by Boyle and Hill, demonstrating their reliance on outmoded evidence, outlier studies, and flawed statistical analyses. In the current authors’ view, their claims portray misunderstandings of the design, execution and interpretation of findings from RCTs in general and of the epidemiology of HIV transmission in sub-Saharan Africa in particular. At the same time they ignore systematic reviews and meta-analyses using all available data arising from good-quality research studies, including RCTs. Denial of the evidence supporting lack of male circumcision as a major determinant of HIV epidemic patterns in sub-Saharan Africa is unsubstantiated and risks undermining the evidence-based, large-scale roll-out of VMMC for HIV prevention currently underway. The present article highlights the quality, consistency and robustness of the scientific evidence that underpins the public health recommendations, guidance, and tools on VMMC. Millions of HIV infections will be averted in the coming decades as VMMC services scale-up to meet demand, providing direct benefits for heterosexual men and indirect benefits for their female partners.
Author details:
Richard G Wamai, PhD (Helsinki), Department of African-American Studies, Northeastern University, Boston, Massachusetts, United States of America; Brian J Morris, PhD (Monash), DSc (Sydney), School of Medical Sciences, University of Sydney, Australia; Jake H Waskett, Circumcision Independent Reference and Commentary Service, Radcliffe, Manchester, United Kingdom; Edward C Green, PhD (Catholic Univ America), Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America; Joya Banerjee, MS (Harvard), GBC Health andGlobal Youth Coalition on HIV/AIDS, Brooklyn, New York, United States of America; Robert C Bailey, PhD (Harvard), MPH (Emory), Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, Illinois, United States of America; Jeffrey D Klausner, MD (Cornell), MPH (Harvard), Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, California, United States of America; David C Sokal, MD (SUNY), Clinical Sciences, Behavioral and Biomedical Research, Family Health International, Research Triangle Park, Durham, North Carolina, United States of America; Catherine A Hankins, MD (Calgary), MSc (London) FRCPC, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. The first two authors contributed equally to this work.
The authors thank Ronald Gray, William G Robertson Jr, Professor of Reproductive Epidemiology, Department of Population, Family, and Reproductive Health Johns Hopkins University; Adrian Mindel, Professor of Sexual Health, University of Sydney; Daniel T Halperin, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Stephen Moses, Professor, Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg; Nelson Sewankambo, Professor of Medicine, Makerere University College of Health Sciences; and Kawango Agot, Director, Impact Research and Development Organization, Kisumu, Kenya; Bertran Auvert, Professor of Public Health, Universit´e de Versailles-Saint-Quentin, Versailles, France for reading the draft of this manuscript and supporting its contents.
oogenhand 
Eww. If you knew how absolutely wrong that article is, and on what levels, and why, you would definitely not be promoting it: Besides the fact that two of the authors are known circumfetishists, the ‘facts’ they are promoting are not ‘facts’. If you are interested in links and studies, do say so.
I am not promoting the article. I never claimed to be DSCI. But ritarabbit does. The trick was to troll DSCI folks with the idea that they want to have sexual relations with African women; after all, Africa is where the AIDS is, and ritarabbit takes a very dim view of my ideas that boil down to that, exactly because of centuries of reproduction with White women, the autosomal DNA of Arabs and especially Jews, is largely White. As women don’t have Y-chromosome, race-mixing of White men with Jewish or Arab women, wouldn’t be that bad.
As regards circumfetishists, where do you place them between (regular)homosexuals and (regular)pedosexuals in perversion?
And Christians have no business promoting circumcision: it is quite clearly against our faith. http://www.udonet.com/circumcision/christian.html
I am not a Christian. But Dan Gayman claims to be one. Dan Gayman is the above-ground theologian of the Dual Seedline Christian Identity movement. And he strongly promotes circumcision.
I believe that circumcision is not bad.
and it is a fact that when at a young age gebreurt it will look much better.
later in life get enough boys are affected and if it happens it will be a lot uglier to see that it was done when you were little.
Therefore, I think she just when every boy must do right after the births.
gets anyone bothering.